【摘要】 目的了解2010年中国CHINET所属14所医院临床分离克雷伯菌属细菌的耐药情况。方法采用纸片扩散法(K-B法)或自动化仪器对临床分离株作药敏试验,并按CLSI 2010年版标准判断药敏试验结果。结果临床分离的肺炎克雷伯菌5 032株和产酸克雷伯菌429株,其中<18岁患者分离的克雷伯菌属细菌占19.4%(1 058/5 461)。62.4%分离株来源于呼吸道标本。药敏试验结果显示,克雷伯菌属对亚胺培南、美罗培南和厄他培南3种碳青霉烯类抗生素的耐药率分别为8.9%、8.9%和10.7%,对头孢哌酮-舒巴坦和哌拉西林-他唑巴坦的耐药率分别为14.8%和16.7%。所有14所医院均分离出对1种以上碳青霉烯类抗生素耐药菌株,其中肺炎克雷伯菌508株,产酸克雷伯菌31株。221株肺炎克雷伯菌和1株产酸克雷伯菌为泛耐药株,主要集中于2所医院(共188株)。结论克雷伯菌属细菌对碳青霉烯类抗生素、头孢哌酮-舒巴坦和哌拉西林-他唑巴坦仍保持良好的敏感性。按CLSI 2010年版标准,肺炎克雷伯菌和产酸克雷伯菌对碳青霉烯类抗生素耐药菌株的分离率分别为10%和7.2%,且耐药株主要集中于2所医院,加强医院感染控制,防止此类耐药菌株在医院内播散至关重要。更多还原

【Abstract】 Objective To investigate the antimicrobial resistance of Klebsiella spp.strains isolated from 14 hospitals submitted to China CHINET in 2010.Methods Disc diffusion test(Kirby-Bauer method) and automatic microbiology analysis system were employed to study the antimicrobial resistance.WHONET 5.4 was used for data analysis according to 2010 CLSI breakpoints.Results A total of 5 461 clinical isolates were analyzed during 2010,including 5 032 strains of K.pneumoniae and 432 strains of K.oxytoca.About 19.4%(1 058/5 461) of the Klebsiella strains were collected from children.About 62.4% of the strains were isolated from respiratory tract specimens.All the isolates kept the lowest resistance to imipenem,meropenem or ertapenem(about 10%),followed by cefoperazone-sulbactam(14.8%) and piperacillin-tazobactam(16.7%).A total of 508 strains of K.pneumoniae and 31 strains of K.oxytoca were resistant to imipenem and/or meropenem.Such carbapenem-resistant strains were identified in all the 14 hospitals.Furthermore,221 strains of K.pneumoniae and 1 strain of K.oxytoca were pan-drug resistant,which were mainly found in the two hospitals located in Eastern China.Conclusions Carbapenems,cefoperazone-sulbactam and piperacillin-tazobactam remain active against Klebsiella spp.The carbapenem-resistant Klebsiella strains are emerging in Eastern China.More efforts should be taken to control the superbugs.更多还原